Effect of Reversal of Neuromuscular Blockade with Sugammadex versus Usual Care on Bleeding Risk in a Randomized Study of Surgical Patients

Rahe‐Meyer, Niels; Fennema, Hein; Schulman, Sam; Klimscha, Walter; Przemeck, Michael; Blobner, Manfred; Wulf, Hinnerk; Speek, Marcel; Sisk, Christine McCrary; Williams-Herman, Debora; Woo, Tiffany; Szegedi, Armin

doi:10.1097/aln.0000000000000424

Cited by 70 publications

(43 citation statements)

References 15 publications

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“…Staals et al in a study of patients with renal failure, found sugammadex had no significant effect on AST, ALT, gamma glutamyl transferase levels and PLT counts compared to the control group [28]. In 2014 Rahe-Meyer et al, in a study of patients undergoing joint surgery on the hip or knee, compared the aPTT and PT levels of patients given sugammadex, neostigmine with glycopyrrolate, or atropine or placebo/spontaneous recovery and found limited levels of increase and reported that there was no other increase in incidence of bleeding [21]. Schaller and Fink in an evidence-based compilation reported that if there is a situation that causes risk of bleeding or that may be revealed by not taking extra precautions with sugammadex, the anticoagulant effects of sugammadex may become clear clinically in such situations.…”

Section: Discussionmentioning

confidence: 99%

“…Again in terms of PT, aPTT, fibrinogen, and D-dimer levels, there was no significant difference between the groups (Tables 2 and 3). Some publications have reported that, though low, there is a potential risk of hemorrhage in the postoperative period due to the minor and temporary lengthening effect of sugammadex administered at the end of the surgical procedure [21,22]. From the point of view of sugammadex and hemorrhagic complications, the European Medicines Agency researched two possible hemorrhagic complications and determined that "obtained proof shows there is an effect of sugammadex on bleeding parameters such as aPTT and PT" [23].…”

Section: Discussionmentioning

confidence: 99%

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Effect of Low and High Dose Sugammadex on the Coagulation and Fibrinolytic System in Rats

Taş

Yağan

Noyan

et al. 2015

Advances in Anesthesiology

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Background. Sugammadex is a new reversal agent that has entered use recently. It is known that with sugammadex some changes in coagulation parameters occur without documented clinical results. Aim of the Work. The objective of this study was to identify effects of sugammadex on liver functions, coagulation, and fibrinolytic systems. Methods. Thirty-six rats were randomized into six groups: Group I, control; Group II, rocuronium group; Group III, sugammadex administered in 16 mg kg −1 dose; Group IV, sugammadex administered in 96 mg kg −1 dose; Group V, rocuronium and sugammadex administered in 16 mg kg −1 dose; and Group VI, rocuronium and sugammadex administered in 96 mg kg −1 dose. After 120 minutes, blood samples were obtained for prothrombin time, activated partial thromboplastin time, D-dimer, fibrinogen, aspartate aminotransferase, alanine aminotransferase, albumin, platelet, and mean platelet volume analyses. Results. Compared to the control group, in all groups measured parameters did not show any effect from a statistical viewpoint either due to the administered drugs alone or due to interaction effects. Conclusion. The conclusion was reached that administration of sugammadex in rats did not have any significant effect on the fibrinolytic system, coagulation parameters, and liver function.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Effect of Low and High Dose Sugammadex on the Coagulation and Fibrinolytic System in Rats

Taş

Yağan

Noyan

et al. 2015

Advances in Anesthesiology

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“…Their findings do not support that 2 or 4 mgkg -1 sugammadex is associated with a longer clotting time. Another double-blinded randomized study enrolling patients undergoing orthopedic surgery confirms that sugammadex does not increase the bleeding risk [87].…”

Section: Longer Clotting Time and Increased Bleedingmentioning

confidence: 95%

A Short Update on Sugammadex with a Special Focus on Economic Assessment of its Use in North America

Zaouter¹,

Mion²,

Palomba³

et al. 2017

J Anesth Clin Res

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Sugammadex offers significant advantages over the current anticholinesterase reversal drugs. Sugammadex used has been approved for the United Stated and for Canada since December 2015 and February 2016, respectively. The present article aims to provide a straightforward and concise review of the most recent literature describing its clinical advantages in routine use. A thorough and cost-effective evaluation has been conducted specifically for North America to determine if its price justifies its inclusion into regular patients' care. The search examined the relevant literature from January 2013 to October 2016. The present narrative review describes how sugammadex could play a crucial role in the modern conduct of anesthesia. The particular emphasis on sugammadex cost-effective analysis performed in this article suggests that this new reversal agent should be considered for a wider use in North America.

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“…While sugammadex produced limited, transient (<1 hour) increases in activated partial thromboplastin time and prothrombin time, it was not associated with increased risk of bleeding compared to traditional care modalities [14].…”

Section: Sugammadex and Surgical Bleedingmentioning

confidence: 99%

Sugammadex: An Update

Ezri

Boaz

Sherman

et al. 2016

The Journal of Critical Care Medicine

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Effect of Reversal of Neuromuscular Blockade with Sugammadex versus Usual Care on Bleeding Risk in a Randomized Study of Surgical Patients

Abstract: Sugammadex produced limited, transient (<1 h) increases in activated partial thromboplastin time and prothrombin time but was not associated with increased risk of bleeding versus usual care.

Cited by 70 publications

References 15 publications

Effect of Low and High Dose Sugammadex on the Coagulation and Fibrinolytic System in Rats

Effect of Low and High Dose Sugammadex on the Coagulation and Fibrinolytic System in Rats

A Short Update on Sugammadex with a Special Focus on Economic Assessment of its Use in North America

Sugammadex: An Update

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